At some point on the last homeward bound 300 mile leg of a trip, I picked up a large spike in the right rear inside dually. Didn't even notice it until the day after I got home when checking the air pressures. I know I was lucky. I replaced both tires on that side.
After that, I had a TPMS installed, and I carry an inflated spare in the storage compartment. To make room, I removed the giant tool box and replaced it with a small fishing tackle box that contains Phillips and slotted screwdrivers, an easement tool (hammer) and a Good Sam roadside assistance card. Those are the only tools I know how to use anyway.